Collagenase injection, needle fasciotomy had similar outcomes for Dupuytren’s contracture

BOSTON — Despite more pain and larger skin ruptures directly after treatment among patients who received collagenase injection, investigators found no significant differences between the treatment and percutaneous needle fasciotomy for Dupuytren’s contracture.

Joakim Stromberg, MD, PhD, and colleagues randomly assigned 156 patients with Dupuytren’s contractures of 20° or more in the metacarpophalangeal joint to receive either percutaneous needle fasciotomy or collagenase injection with Clostridium histolyticum. Outcome measures included patient-reported outcome measures, Quick-DASH scores, Unité Rhumatologique des Affections de la Main (URAM) scale and VAS scale scores.

In his presentation at the American Society for Surgery of the Hand Annual Meeting, Stromberg noted patients who received collagenase injection experienced significantly more pain and larger skin ruptures at 1 week.

Of the 156 patients, 40 patients were evaluated by ultrasound directly after treatment and after the cord had ruptured. Results showed no significant difference in rupture length of the cord between the percutaneous needle fasciotomy group and the collagenase injection group.

Stromberg noted a significant increase in recurrence rate between 1 year and 2 years postoperatively. However, he added there were no significant differences in outcome measures between the two groups.

“You can see that the passive extension was the same in both groups, the URAM score was the same [and] the Quick-DASH score did not differ either,” Stromberg said. – by Casey Tingle

Reference:

Stromberg J, et al. Paper 67. Presented at: American Society for Surgery of the Hand Annual Meeting; Sept. 13-15, 2018; Boston.

Disclosure: Stromberg reports no relevant financial disclosures.